Recurrence of pericarditis after influenza vaccination: a case report and review of the literature

Abstract

Background: This case report describes a patient with pericarditis likely attributed to influenza vaccination (positive rechallenge), with a literature review.

Case presentation: A 87-year old patient developed pericarditis after influenza vaccination, with acute chest pain, without ECG abnormalities or increased cardiac enzyme levels. Echocardiogram showed moderate pericardial effusion. Recovery was obtained through steroids One year later, few days after re-immunization, the patient experienced the same symptoms and was admitted to hospital with diagnosis of recurrence of pericarditis with severe pericardial effusion, again treated with steroids. Other possible causes were ruled out and the cardiologist recommended against influenza vaccinations in the future; the patient did not experience recurrence of pericarditis in the following 6 years. Cases of pericarditis following influenza immunization in the literature were also reviewed.

Conclusions: Pericarditis following immunization for influenza is very rarely reported in the literature. In a few cases, influenza vaccination seems likely responsible. We suggest considering recent immunization in patient's history as part of the differential diagnosis in elderly with chest pain.

Keywords: Adverse event following immunization; Case report; Influenza vaccine; Pericarditits; Rechallenge.

Fig. 1

Timeline of events

Fig. 2

Transthoracic echocardiogram (M-Mode, subcostal four-chamber and apical four-chamber view) showing moderate pericardial effusion (arrows)